FAQ: Botox


Beverly Hills Facial Plastic Surgeon Dr. Babak Azizzadeh frequently answers questions from patients on realself.com. They are separated into categories below. If you do not find an answer to your question here, please contact us or call us at 310-657-2203.


Before and after botox

Q: I’m 8 weeks past treatment and have severe problems after Botulinum Toxin for frown lines and crow’s feet.

I have under eye bags, dry eyes, eye pain, cheek ptosis, and saggy skin. Will I fully recover from this?

A: Botox is temporary.

I cannot tell you that you will fully recover without seeing any pre- or post-Botox pictures, but I can tell you that Botox is only temporary. The effects of Botox last only 3-4 months.

Q: Does a person have to stop using Botox and fillers before they seek a facelift consultation?

If yes, how long should they stop using fillers and Botox before the consultation?

A: No need.

There shouldn’t be any need to stop Botox injections prior to a facelift consultation.

Q: Can Botox Cause Permanent Facial Nerve Damage?

I have been suffering from horrific pain in my face for 18 months. I never had anything like it before. So what happened 18 months ago that could have triggered this? I had Botox for a frown mark. Immediately afterwards I developed a heavy head and headaches that never really went away. My pain is in the frontal area – in my forehead, behind my eyes, in my nose, cheekbones and back of head & neck… all along the nerve paths. Could Botox have caused damage to my nerves?

A: Not likely.

Botox only lasts in your system for about 3-4 months so it is not likely the cause of what you are experiencing. Q: Can Botox be mixed with Sculptra injections?

A: Not in same appointment.

It is usually best not to get them done in the same appointment, but spaced just a bit apart, they work great together.

Q: Best treatment for wrinkles around mouth after Ulthera treatment?

I had Ulthera treatment around my mouth 6 months ago. I still have fine wrinkles around my mouth. What do you recommend to eliminate these wrinkles?

A: Botox, Fraxel, and Retin-A

Fraxel resurfacing and Botox are probably good options for you. If you are not already on Retin – a, this is a must have in everyone’s medicine cabinet!

Q: 40 Units of Botox didn’t work?

I had 40 units of Botox injected for my 11s. 6 Days later its not working at all. I still have full movement. I’m a man in my 40s with a large build and I exercise a fair amount and eat healthy. Is this common? Did I receive enough Botox? What can I do now?

A: 40 units should be sufficient.

Botox takes 7-10 days to take full effect. Wait the 10 days. If still nothing, go back to your provider.

Q: How to Treat Deep Smile Lines?

I have deep smile lines on my face. Is a facelift or plastic surgery my only option? Are dermal fillers a possible solution?

A: Dermal fillers a possible solution

You can certainly try dermal fillers as it is a safe and very effective way to treat smile lines. Just make sure your facial plastic surgeon or dermatologist evaluates your cheeks for volume lids as this tends to often be a culprit for deep laugh lines.

Q: Is Botox an Option for Bands Showing After Neck Lift?

I had a neck lift with platysmaplasty 4 months ago. I think that maybe I had too much lipo just under the chin, because when my head is tilted back, very small bands show and pull, and a larger band shows and creates a dent. What is the remedy for this? Is Botox on these bands an option?

A: Botox as an option for bands showing after neck lift

If you have very small bands that show and pull, and a larger band showing and creating a dent while tilting your head back, Botox could indeed successfully address the issue. However, I would suggest you evaluate your options with your surgeon prior to deciding what is best for your unique and individual case.

Q: How Do I Get Rid of the Horizontal Crease Between my Eyes?

At the very top of my nose, between my eyes is a crease that appears as if my forehead is slipping down, which it probably is because when I put on a tight headband it lifts and softens. Would Botox help with this?

A: Getting rid of wrinkles between the eyes

Most likely, Botox will help reduce the appearance of the creases between your eyes. You should consult in person with a facial plastic surgeon to make sure Botox is the correct treatment. If you have more severe sagging, other treatments might be better.

Q: How Do I Go About Choosing a Surgeon for Botox?

I am nearly 25 and im so shocked at how much my skin seems to have aged lately. I’m thinking about fillers and Botox but really frightened that it won’t look natural. How do i no how to choose the right surgeon?? Help please 🙂

A: Choosing a good Botox injector

Since you are young it is important to find a doctor who is very experienced with Botox and filler injections. I would recommend consulting with at least 2-3 different facial plastic surgeons or cosmetic dermatologists to see what they think you need. You can then compare what they told you to see if they are all recommending the same treatments or if 1 doctor is more aggressive than the others. Ask to see before and after pictures of younger patients as well so you can have a better expectation of what your results will look like. At 25 you will probably only need minimal Botox or filler injections to achieve your desired look or help to prevent wrinkles from forming in the future.

Q: Damage from Facial Paralysis- How to Find Best Botox Providers For This Issue?

I have a face damaged from a 15 year old Bell’s Palsy /Ramsey’s hunt – could have been either. I have been all over to get opinions but resist any permanent work as my face has multiple issues. I have had luck with Botox in the eye and fr spasms, but how do you find someone who is well trained enough in this area to really provide some solutions? Plastics, Ent nueromas??

A: Seek a facial plastic surgeon with experience in facial paralysis treatments

Botox is one of the most effective treatments for patients with Bell’s palsy, partial facial paralysis and synkinesis. You should find a doctor who is an expert in facial paralysis. Without expertise in facial paralysis/Bell’s palsy it will be difficult for a doctor to know exactly where to inject the Botox to give you the best results. Before you let someone perform Botox treatments on you, ask how much experience they have using Botox for facial paralysis. Overall, a facial plastic surgeon is the best board specialty (as opposed to ENT, dermatologist or general plastic surgeon) to perform the Botox injections.

Q: First time Botox user with questions

Does it generally take longer to see results in the frown area as opposed to the crow’s feet? Does it take longer to see the effects of Botox the first time you get it as opposed to subsequent visits?

A: Botox results

Botox results really vary from patient to patient. Also, the dosing (or units used) of the product will have an effect on when you see results and how long the results of the Botox last.

Q: Can Botox Help Alleviate Symptoms of Bells Palsy?

My husband woke to facial paralysis this week. Each day the effects are more prominent. Because he is in face to face meetings every day, he is obviously very conscious of the way he looks and speaks. Can Botox help alleviate the symptoms of Bells Palsy?

A: Botox commonly used in Bells palsy patients

Botox is actually commonly used in Bell’s palsy patients for control of uncoordinated movements, which is referred to as synkinesis. Botox can help alleviate some symptoms of facial paralysis or Bell’s palsy, but it is not a cure.

Q: Dysport vs Botox – which is better?

I’ve heard Dysport is cheaper than Botox, but is it better, the same or worse? Has anyone tried both to be able to compare?

A: Botox vs Dysport

Botox and Dysport are very similar. However, there are a few very slightly differences, which an expert injector can use to your advantage. Dysport diffuses (spreads out) a little more, while Botox stays where it is injected a little better. So depending on what your goals are the doctor can use one or the other to better meet your goals. The results of Dysport may appear sooner, but both last for about the same length of time. Some doctors do charge less for Dysport, but this really depends on the doctor’s preference.

Q: Fillers or fat grafts for neck bands?

I recently had platysmal surgery and have no results. The bands look no different, and if anything worst. I am looking into a revision or fat grafting if its worth it.

A: Neck band treatment options

Fat grafting will not address platysmal banding because it is mostly for the face volume restoration. You will likely require surgery to revise the area. You can also consider Botox or Dysport as temporary measures.

Q: Brow lift with Botox

Has anyone here had a brow lift done with Botox? I know this isn’t a permanent fix but i’ve been reading more and more about it and am interested in it but wanted to hear some first hand experiences first.

A: Botox Browlift

Botox, Dysport and Xeomin can be an excellent non-surgical alternative for subtle brow elevation in the appropriate patient. The potential complication profile is limited in the hands of an experienced facial plastic surgeon or dermatologist. In addition to the Botox, you might want to look into injectable fillers to volumize the brow and temple areas. Volume depletion is a big factor in this area. I like using Restylane to volumize the upper brow region and Sculptra for the temples.

Q: When Stopping the Use of Botox, Do Wrinkles Become Worse Than Before Treatment?
A: Wrinkles will go back to they were before treatment
Your wrinkles will go back to the way they were before treatment. If you are unhappy with the way it looks you can just start getting Botox again.

Q: Is It Safe to get Botox 10 Days After IPL?
A: Yes, completely safe
Yes, it is completely safe to have Botox right after an IPL treatment, or 10 days after. The two together often provide nice results.

Q: Should I Go See a Plastic Surgeon or a Dermatologist for my Botox Injection?
I decided to go for my first Botox injection. I have decided to stay away from Botox party or med spas. I am going to the best plastic surgeon or dermatologist. I wonder which one is better. The surgeon or the dermatologist. Thank you in advance. I am in southern California. But I don’t mind traveling!
A: Either is fine, experience is the key
You can see either a dermatologist or a plastic surgeon. What is most important is the level of experience the physician has with the product. This will allow you to achieve the best and most natural looking results, and to avoid any complications. You could also consider going to see a doctor who is a trainer for Botox (i.e. teaches other doctors how to inject). I am a trainer in Beverly Hills if you are interested.

Q: Need to Fix Crooked Smile – Will Botox Work?
I’ve had a crooked smile – I think since birth. I think that it may be a problem with the side of my face – rather than just the smile – let me know your thoughts. It’s become a bit of a lifestyle problem – your input is very much appreciated. Will a Botox injection work? The cost is around $500 for a 6-month result? Thank you,
A: Yes, Botox can correct a crooked smile
Yes, Botox can be used to correct asymmetry or a crooked smile. I would suggest going to a facial paralysis expert as we use Botox for this exact reason in many of our patients.

Q: How Soon After Botox is it Ok to Get Brows Waxed?
Hello, I had 30 units of Botox for 11’s between my eyebrows and crows feet for my 57-year-old face. All is going well, and I’m pleased. It has been 2 weeks; it is alright to have my eyebrows waxed now? Thanks for your help,
A: Yes, 2 weeks is fine to get waxed after Botox
2 weeks is fine to go get your eyebrows waxed after Botox, probably only a day or two would be sufficient.

Q: Should I Be Concerned That Botox Could Cause Eyebrow Drooping?
I want to use Botox injection to treat the very shallow horizontal forehead lines and the very deep frown lines between my eyebrows. I’ve heard that forehead lines injection run a bigger risk of eyelid drooping. Should I just treat the deep frown lines between my eyebrows to avoid eyelid drooping?
A: Go to an experienced injector and you should be fine
As long as you go to an experienced Botox injector, they will know where to place the Botox and how to make sure you do not get eyelid brow drooping.

Q: Is Botox a Possible Treatment to Get a Wider Eye Appearance on a Closed-Set-Eye Woman?

A: By injecting the glabella region with Botox, you can create a ‘lift’ in between the brows, which will possible create wider set eyes.

It’s hard to say without assessing your face in person. Make sure you see an expert facial plastic surgeon who knows how to implement the correct treatment for your face.